Smith no longer is experiencing the blurred vision that signaled Sunday's concussion and forced him out of the 49ers' 24-24 tie with the St. Louis Rams.

To participate in Wednesday's practice, Smith first received medical clearance from an independent neurologist at Stanford University. He must undergo further evaluation before being cleared to play in Monday night's NFC showdown between the host 49ers (6-2-1) and Chicago Bears (7-2).

Regarding his availability for Monday, Smith noted: "It's not up to me. It's up to the doctors, and there's a lot of stuff they're looking at. At this point, it's early."

Smith spoke Wednesday for the first time since enduring the concussion, which also triggered a headache and nausea later Sunday night. His vision first became blurred when he converted a fourth-down quarterback sneak.

"It's tough to play quarterback without your eyes, when you can't see and see well," Smith said. "It's 22 guys screaming around out there. You see bits and pieces of things, and flashes of things, and those all help you make decisions.

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"All of a sudden it was a bunch of stuff out there that I couldn't make out. And I just felt I couldn't help the team."

Smith said his vision became further impaired when he sat down on the 49ers sideline after that drive, which culminated in his 14-yard touchdown pass to Michael Crabtree.

Neurologists believe a helmet-to-helmet hit from the Rams' Jo-Lonn Dunbar might have contributed to Smith's concussion. That play occurred at the start of Smith's final series and near the end of the first quarter. Smith confirmed he was examined between quarters by 49ers medical director Dan Garza.

"I felt fine after that hit, though," Smith said. "When I came up off the sneak, my eyesight had gone wrong. I tried to blink that one off and thought it might go away and played the four or five plays after that."

This concussion was "more severe" than the one he endured after last season's home opener against the Dallas Cowboys, although vision problems were a similar symptom.

Despite the hindered vision, Smith completed all three of his passes after that fourth-down sneak, including the touchdown to Crabtree. How did Smith do that? "It's a great question," Smith responded. "It wasn't like I was blind. But I certainly didn't feel I should go back out there."

Several of Smith's teammates are optimistic Smith can return Monday night.

Tight end Vernon Davis said: "We're hoping Alex is ready to go, because we need him, even though we have (Colin) Kaepernick and he can get it done."

Kaepernick, who relieved Smith on Sunday, said he received a similar workload Tuesday as in past practices and that he'll be "very prepared" in case he needs to start or play significantly.

The Bears also are dealing with the NFL-mandated, post-concussion process for their quarterback, Jay Cutler, who left Sunday night's loss to the Houston Texans with a second-quarter concussion.

The Bears did not practice Wednesday, and Cutler's availability is more suspect than Smith's, considering Cutler missed a game last season with a concussion. Bears coach Lovie Smith told Chicago reporters that Cutler is "feeling a whole lot better."

"We want their best, and I want Cutler to play," 49ers running back Frank Gore said. "It'll be like a playoff game: two good teams on 'Monday Night Football,' and everybody will be watching."

The 49ers will hold full practices Thursday through Saturday before a light walk-through session Sunday, leaving Smith ample time to participate fully in practice.

During Wednesday's 20-minute access period for the media, Smith looked as he does at every practice, aside from the black jersey. He wore his gold helmet, a play-calling wristband on his left forearm and a short towel off the right hip of his red shorts.

Smith did not miss any practice time with his last documented concussion, last season against Dallas.

Left tackle Joe Staley and reserve guard Daniel Kilgore, the only other 49ers to suffer concussions this season, did not miss the ensuing game.

All the 49ers' other key players appeared to practice Wednesday, including several who suffered or aggravated injuries Sunday: Gore (hand, ribs), guard Mike Iupati (knee) and linebacker Aldon Smith (shoulder). Gore said he underwent postgame X-rays on his ailments and that "I'm cool." Aldon Smith said his shoulder isn't hindering him.

Kicker David Akers said of the 41-yard field goal attempt he missed in overtime: "I was trying to just smoothly kick and not overhit it. I kind of fell off the ball. When I did that, that's why it kind of went left. ... Obviously, I didn't do what I needed to do at that time."

Four 49ers are leading their respective positions in NFC Pro Bowl voting at NFL.com: linebacker Patrick Willis, Iupati, Akers and special-teams candidate C.J. Spillman. Willis is on pace for his sixth Pro Bowl trip in six seasons, and Akers made last season's team. Iupati and Spillman are bidding for their first Pro Bowl berths.

Sitting in second place at their positions are Davis, Staley and defensive tackle Justin Smith. In third place are Gore, right tackle Anthony Davis, center Jonathan Goodwin and linebacker NaVorro Bowman.

Vernon Davis is opening an art gallery next month in San Jose's Santana Row. Gallery 85's grand opening will take place as a Dec. 10, invitation-only event benefiting The Vernon Davis Foundation for the Arts. The gallery will feature work from various artists beside Davis.